Hydrosalpinx: what you need to know before an IVF program

Definition and Causes

Hydrosalpinx is an obstruction and inflammation of the fallopian tubes (uterine tubes) that causes dilation and fluid accumulation. This fluid buildup disrupts the permeability of the tubes and creates an unfavorable and toxic environment that negatively affects embryo quality and implantation. It significantly reduces the chances of conception. Since the fallopian tubes play a key role in the fertilization process and the transport of the embryo to the uterus, hydrosalpinx becomes a major obstacle to motherhood.

According to WHO, the prevalence of hydrosalpinx among women suffering from tubal infertility is about 30%. In countries with good quality healthcare, this rate is lower, thanks to early diagnosis and prevention of inflammatory diseases. Main causes:

• genital organ infections (e.g., chlamydia, gonorrhea);
• surgeries on pelvic organs;
• endometriosis and its complications;
•  
• consequences of ectopic pregnancy.

Treatment most often involves a surgical intervention aimed at improving fertility and restoring the ability to conceive. In some cases, it is recommended to remove the affected tube to increase the chances of successful implantation. According to clinical studies, after salpingectomy, the pregnancy rate in IVF cycles doubles: from 18-20% to 35-40%. Additional studies indicate that timely intervention reduces miscarriage risk by 15 to 20% and increases the chances of delivering a healthy baby. These data confirm the importance of a comprehensive approach to treatment before IVF.

Symptoms

In a large part of women, hydrosalpinx is asymptomatic and is only detected during infertility examinations. Possible manifestations:

• Pain in the lower abdomen or pelvic region;
• Unusual discharges;
• Sensation of heaviness or discomfort in the pelvis.

Diagnostic Methods

Different methods are used to establish the diagnosis:

• Ultrasound – detects the presence of fluid in the tubes (accuracy of 70 to 85% depending on equipment and specialist’s experience);
• Hysterosalpingo-contrast Sonography: examination of tube permeability using a saline solution;
• Hysterosalpingography (HSG): X-ray with contrast agent;
• Laparoscopy: “gold standard” for diagnosis and also a treatment method.

Impact on IVF Effectiveness

Hydrosalpinx significantly reduces the effectiveness of IVF programs:

• Standard IVF: fluid from the affected tubes alters the uterine environment and prevents embryo implantation;
• FIV with egg donation – even when using high-quality donor eggs, toxic fluid can damage embryos and decrease pregnancy chances;
• Double donation IVF – inflammatory fluid continues to have a negative effect, increasing the risk of inflammation and miscarriages.

In all protocols, hydrosalpinx has a toxic effect on the embryo, prevents implantation, increases the risk of complications (ectopic pregnancy), and the risk of spontaneous miscarriage. Sometimes removal of hydrosalpinx is necessary.

Scientific data confirm that removal of affected tubes (salpingectomy) before IVF is a preventive measure aimed at improving outcomes.

Modern reproductive medicine offers strong chances of pregnancy even with hydrosalpinx. The latest technologies are used: high-precision laparoscopy, methods to improve embryo quality, and personalized IVF protocols. Treatment can last from a few weeks to several months, depending on the complexity of the situation, but it results in a significant increase in conception chances.

A few recommendations:

• Regularly undergo examinations, even in the absence of symptoms;
• Consult experienced specialists for diagnosis and treatment of hydrosalpinx;
• Medical therapy: effective in active inflammation but less so in chronic hydrosalpinx;
• Laparoscopy: a minimally invasive method to remove or restore tube permeability, but the risk of recurrence is high;
• Salpingectomy – radical removal of the affected tube before IVF, eliminates the negative effects of fluid, which significantly increases the chances of conception, by increasing implantation rates and pregnancy success. It also improves endometrial receptivity by increasing the expression of the HOXA10 molecule, responsible for successful implantation.

At NatuVitro Clinic, specialists are ready to support you at every step of your journey to motherhood, offering a personalized approach, modern methods, and expert guidance.